Abstract
The European guidelines for pulmonary hypertension (PH) have recently been updated and contain important new recommendations, especially with regard to treatment goals and combination therapy for pulmonary arterial hypertension (PAH). Escalation therapy should be initiated if patients in WHO functional class III or IV fail to improve or if patients in functional class II deteriorate. The ultimate objective is to have all patients in functional classes I or II. In order to avoid serious toxic side effects for the patient, it is important to be aware of potentially significant drug interactions.
PAH, however, accounts for only about 4% of PH cases—however, all existing specific treatments are approved only for PAH. This means that for approximately 96% of patients with PH, no specific medication is available. PH due to lung disease and/or hypoxemia shows some differences compared to PAH. In the absence of specific drugs, the only option in patients with chronic hypoxemia that is recommended by current guidelines is optimal treatment of the underlying lung disease including long-term oxygen therapy. Patients with “out of proportion” PH due to lung diseases should be enrolled in randomized controlled trials targeting PAH-specific drugs.
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Acknowledgments
This article is based on a presentation given at the “5th International Ventavis® Symposium 2009, Athens”, sponsored by Bayer Schering Pharma AG.
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Palazzini, M., Hoeper, M. & Sitbon, O. Current pulmonary hypertension guidelines and remaining controversies. Clin Res Cardiol Suppl 5 (Suppl 2), 3–8 (2010). https://doi.org/10.1007/s11789-010-0017-8
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DOI: https://doi.org/10.1007/s11789-010-0017-8